Serum Cardiac Troponin I As a Diagnostic Marker of Myocardial Injury Among Human Immunodeficiency Virus Infected Children in Ilorin Kwara State Nigeria

Abstract

Background: Cardiac Troponin I (cTnI) is a unique marker of myocardial injury. It is the most sensitive and specific of the cardiac markers. Studies have shown its elevation among Human Immunodeficiency Virus (HIV) infected subjects. Most of these were in adults hence we determined the use of cTnI as a marker of myocardial injury among HIV subjects. Methods: The study was a comparative cross-sectional study among 100 HIV - infected children aged 2 – 14 years and equal age-matched HIV-uninfected controls. Recruitment was through the Paediatric HIV and outpatient clinics of the hospital respectively. Both groups had serum cTnI assay (normal is <0.1μ/L) over four months period. Data analysis was done using the SPSS® v 20. Normally distributed data had mean standard deviation while not normally distributed data had a median with an interquartile range determined. The diagnostic performance of cTnI was determined using the Receiver Operating Characteristics curve. Significant p is < 0.05. Results: A total of 200 (subjects and controls) were studied. The mean age of participants was 9.42 years. There was a significant difference in the median (IQR) cTnI of HIV-infected subjects [73.8 (51.8 – 149.1)] compared with HIV uninfected controls [25.0 (13.3 – 51.4)] p < 0.001. The prevalence of myocardial injury among subjects was 48% compared with 8% among controls, also statistically significant (p < 0.001). Serum cTnI has 91.3% and 88.9% sensitivity and specificity respectively. Conclusions: The prevalence of myocardial injury was high in HIV - infected children. Serum cTnI is a reliable predictive marker of myocardial injury.